Patient's Query
Hello doctor,
I recently had an MRI that found a 9 mm pineal cyst and a 3 mm cavernoma in the cerebellum. For the past nine years, I have had chronic headaches that do not respond to medication or botox. I also experience sensitivity to light, floaters, flashing lights, nausea, and sleep issues. My vision has worsened, and I have symptoms like ringing in my ears, head pressure, and blurry vision. Despite these symptoms, my CSF flow studies show no obstruction from the lesions.
Surgeons are hesitant to remove these cysts, calling them incidental despite my severe symptoms. What could be causing my issues, and should I take anything to lower my intracranial pressure, given my symptoms and papilledema?
Kindly help.
Hello,
Welcome to icliniq.com.
I can understand your concern.
It looks like you might have intracranial hypertension, which could be idiopathic if your cerebrospinal fluid test is clear of infection. It is a good idea to have a lumbar puncture to measure the opening pressure and check for any infection.
If the cerebrospinal fluid is clear and the pressure is high, it could be idiopathic intracranial hypertension. Have you tried Acetazolamide or Topiramate? These medications might help with your symptoms.
I hope that you got your answer.
Please let me know if you need any help.
Take care.
Patient's Query
Hello doctor,
Thank you for the reply.
I went to the emergency hospital. The neurologist said it was safe to do a lumbar puncture, but the neurosurgeon advised against it due to the risk of brain herniation from my pineal cyst and cavernoma. So, unfortunately, I cannot undergo a lumbar puncture. I have been dealing with these symptoms for nine years now.
Should I try Topiramate to see if it helps? What types of infections could be involved in this?
Kindly help.
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern.
While it is a relative contraindication, it is not an absolute one. Please try Topamax 25 mg once a day, or you could try Acetazolamide 250 mg, one tablet three times a day. These medications should help reduce the pressure.
Tuberculosis (TB) is endemic, so we often consider it a differential diagnosis for chronic headaches with papilledema. However, in your case, it may be idiopathic intracranial hypertension (IIH). I hope the medications will be effective.
I hope I have answered your question.
Let me know if I can assist you further.
Regards.
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Answered byDr. Florilyn Joyce Chulsi Bentrez
Medically reviewed byiCliniq medical review team
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